3rd week in home health, ready to quit

hoolahan, ASN, RN · Nov 12, 2004

And the saga continues....was told today I have to work the next 2 week-ends because the week-end nurse is taking those 2 week-ends off.. let me see if I can add that right...19 days straight before a day off. Oh, and this is the big one...the day after thanksgiving (which I have to work), they want me to run the office, because no one else will be there. I barely know what I am doing in the field...much less how things are done in the office......good grief. 2 full time nurses gave their 2 week notice this past monday..that leaves me (the only full time nurse during the week), and the nurse that works the week-ends. How many different ways do I need to say "I QUIT !" This is just getting to comical to be true.

What?? You won't get 2 days off during the week? I hope you will be getting OT and aren't salaried!!

It's official, your job sucks! Get out, life is too short for that kind of abuse. Contact other agencies if this is what you want to do, but what you are describing is unsafe! I cannot believe they are putting you in charge! That is what salaried supervisors are for. You really better put your foot down on that one! What is nurses call out? What if a HHA calls out? Are you going to have to make the visits?? What about referrals?? (Personally, if I were you, I would say NO to all referrals, claim ignorance!) You are crazy if you accept that responsibility. You have to emphatically state you will NOT do it, and put it in writing to the DON!!!

Run, don't walk from this place. You could work for any agency in the meantime at this time of year until you find what you like!

barefootlady, ADN, RN · Nov 13, 2004

Oh, SRBear, can I relate to every word you have written. In the last 2 days 3 nurses have given notice, 2 of them won't work another day for my company, they are moving anyway and said there is no way they want any more headaches. I have been informed that I have to do 2 shifts of call per week, every other weekend, and the list goes on and on. To make matters worse, The clinical director, who told me when she hired me, she would pick up call when things got heavy has now decided she can't do that anymore, the casemanager is not willing to do any extra, one nurse is going on vacation, he just had a week off 2 weeks ago, and that throws me covering as back up call, on Thanksgiving, and Christmas Eve, and New Years's Eve plus seeing whatever patients that must been seen according to them. I am not buying a book or wasting any money on how to be a better HH nurse. I am seeing 5 or more patients a day, doing hours of paperwork at home free of pay, putting miles on my car that somehow the mileage pay is always off by at least 100 bucks, and now this. I may not be the biggest brain but I do know a scam when I see one or smell one, this smells like a load of bull---- to me. I will be checking on a job, in a hospital, soon. I was a nut for not taking it when the lady called me. Now I will be calling her back. I like the patients and the families, but this is not for me and as soon as I can get out I am gone.

renerian, BSN, RN · Nov 13, 2004

I have seen so many companies/home health treat nurses this way. Pity. They won't stay. Is this a national for profit chain?

renerian

RNTN27 · Nov 16, 2004

Bear, Hi! I am also a home health nurse, I have worked in homehealth for 3 years now. I tried it at first because I needed a job that I could do on the weekends, make decent money and still be able to go to school full time. I worked there as an LPN for 1 year and when I graduated from RN school they hired me full time. I am the first to admit that home health nursing is a diffrent world!! Although it is one of the most rewarding jobs I have ever had. Don't be afraid to stand up for yourself, tell them that you don't know how to do what they are asking of you and that they need to show you!! Believe me if their turn over rate is like ours they will do anything to keep you. :uhoh3: I wanted to quit after 3 weeks of the RN paperwork myself, however once you learn it, it's not that bad. I suppose it took me a good year to get it all down, but I assure you, I had to ask many questions. Try to give it at least another month and then if you are still unhappy then maybe you should try to find another job.With the current nursing shortage I am sure you won't have trouble. GOD be with you and GOOD LUCK!:)

DDRN4me · Nov 17, 2004

I'm so sorry to hear how horrible`this experience has been for you . If the agency is only 2 1/2 years old , amybe the management doesnt have the organization and the management skills they need. Don't give up on the whole concept...if things don't improve there, try a more established agency...those clients need someone with your background!! best of luck..from someone who has been there , done that!!

MadelineGlass · Nov 18, 2004

Then how do we make money?!!:uhoh21:

I dont get paid 'in the office'. only per visit. I am going broke!! I have been doinh Home Health 3 months.....ok with paperwork but how in the world do you make a living at it!!!!!!!!!!11

:rolleyes:

Well... not sure what the words of encouragement are.... Home health is a great world, but quite different than hospitals for sure. It does take a while to get through the paperwork, and understand the new language. I might suggest that when you get off your route, see if you can go back to the office to have someone teach you things that will help with documentation and paperwork. Ask a supervisor to assist you. If they value their staff (and you ) , someone will teach you one on one, if you can get no assistance, I would suggest finding a new agency who cares about their employees. It would seem to me that if the supervisor has no interest in teaching you this new world of nursing, and spending time with you to learn, then they probably have very little care and concern for the staff in general. Home care is a very rewarding field, and gives great pleasure to make a difference in the lives of others on a personal level, patient and families. Home care is delightful, but the paperwork can be a problem, if you do not understand it. It is not bad after you learn the forms, etc.
Take care and Good luck to you.

MadelineGlass · Nov 18, 2004

OMG I am freaking out!! i had absolutly no training, (did home train on oasis on my own) and out in field with 4-5 pts a day and all the Soc and recerts and post hospitals on my first week in home health. You mean thats NOT NORMAL!!???

I have it calculated that i make about 4 hour. count in phone time coordinating disciplines, supplies, aides , LVN's , reports, oasis, communication notes, and the coding (which I never saw before october this year!) , gas, drivie time and I seem to be paying the company to go there!!!!!!!!!!!!!!!

Help what do i do

I ABSOLUTLY LOVE HOME HEALTH, my pateints and the docs love me. This is my place but I dont see me making a living.!!!

I was supposed to start with 2 pts.per day this week, building up to 3 at end of week. Next week starting at 3, building up to 4, then next week, full load (and I have no idea how many that will be). This is what was told to me by the nurse orienting me. Well the nursing supervisor is not sticking to that. This morning she told me I had to do a SOC, along with my 3.....this start of care was about 45 miles from where I would be, and just seeing these 3 today I knew I would log about 100 miles. I told her that was not how things were set up for me, and I got this story about how pts. had to be seen, I could worry about the paper work later. Later when...on my own time....? I told her I had been in nursing way too long to start working for free now, and that I would see my 3 pts. today, but it would be my last day. She called me about an hour later...asking me to think it over on the week-end, and that HH nursing changes a lot, and I must be flexible. I told her I was still in orientation, and if they could not stick to what they said my load would be, then maybe this job was just not right for me. I can be flexible....but I am still learning this job, and I feel they are not as concerned about what kind of job I do, just as long as a pt. gets "seen" Maybe I am being unrealistic. But dang it, I feel like I have been lied to and taken for granted already. This is why I left the hospital...just being treated like a number, being given too many pts. to actually give good nursing care to. But I see now, this seems to be happening in all areas of nursing. I am going to stick it out for a while, but I will be searching for other avenues of employment. You know the old saying "the best time to find a job is when you already have one!" The sad thing is that this HH company was started by a bunch of nurses 2 1/2 yrs ago. How quickly we forget !

barefootlady, ADN, RN · Nov 20, 2004

Aii I am seeing is one big scam regarding what is written and what is really done for these patients. I do not think there is one good reason for the government not doing a through investigation of the home health business. I do not see much in the way of positive results for the patients, only money for the company and the doctor. I agree with Madeline, how do people make a living at this and really do the job?

Traveler · Nov 21, 2004

Where I work there are LOTS of positive results for our patients and wonderful patient care. The government does watch the hh industry pretty closely. When PPS came into being many hh agencies shut down because there was lots of abuse in the system but they have made it hard in the way of documentation requirements, etc.

I can say that I have never done anything unethical in my position and knowing that I am helping my patients makes up for the headaches with the paperwork. Many of our patients really depend on us and we do make a very positive difference. I am able to use all of my nursing skills in home health.

The money is there in home health, it just depends on many things. Some companies pay better than others- as in any other job. I am per visit and some days I make tons of money and others I make less than the HHA's. It averages out though to a pretty good wage. I am able to do much of my paperwork in the comfort of my home after everyone has gone to bed. I love the flexibility. Even though I am per visit, I have stayed at a patient's house for over 3 hours because there was a need.

Home health certainly is not for everyone. I, for one, can't stand being cooped up in a building all day. I like that every day is different. People are pushed out of the hospitals so quickly now that there is a big need for what we do. Routinely we catch mistakes and keep people out of the hospital by addressing a problem when we see it in the home.

hoolahan, ASN, RN · Nov 21, 2004

Aii I am seeing is one big scam regarding what is written and what is really done for these patients. I do not think there is one good reason for the government not doing a through investigation of the home health business. I do not see much in the way of positive results for the patients, only money for the company and the doctor. I agree with Madeline, how do people make a living at this and really do the job?

Wow. I am sorry you are having such a bad experience. I am not sure exactly who you are speaking about when you say "one big scam regarding what is written and what is really done for these patients. " Are you saying here? or in your agency? If what you say is true, then you may be party to fraud. I have been in that unfortunate situation once myself, when I tried out HHA supervision job. It was an eye opening experience to see first hand what Medicaid fraud is, and I was also suprised by how widespread it is. I am also relieved that action is taken when this is reported.

As far as positive results, again, I am sorry you have not been able to find rewards in your job. I personally find this kind of nursing very rewarding. You do not feel satisfaction when you are sent to assess a wound, recommend the wound care and go back to find it 50% healed a week later? I do! What about the new colostomy pt or new diabetic who is so afraid and your teaching makes them feel able to manage the major changes in their lives/bodies?

Sure, there are bad days, I really had a bad day today, which I will either dicuss in the Typical day thread, or a new one, haven't decided yet, but the good still far outweighs the bad for me.I am paid well, but I know my ahency loses money. Every time a supervisor retires, they are not replaced and the work is multiplied for the existing managers and secretaries.

Then again, I am per diem now, so my stress level is much lower than a FT case manager's.

I still think this is the best hands-on nursing that I have ever done.

barefootlady, ADN, RN · Nov 21, 2004

I have been rewarded with my patients care and I am doing my job, but, as I stated in an earlier post, 3 nurses quit in one day, I have had to cover for them, I have been to the homes of some of the people they were taking care of, I know the care was not given. I talked to the super, and CM about this, I was given some sort of explanation like, well some nurses are not as secure in their skills. Big whoop, are they even assessing. Also noted that supplies were ordered and never got to the home, told CM and it is being checked on but I have a feeling nothing will happen. At the weekly meeting it seems more interesting to gossip than discuss issues that need addressed. I expect work to be done, if it is not done, then there should be a good excuse, one person stated they were too tired to work that day, came to the office for 1 hour, saw 3 patients, and then disappeared. I was asked to add one of their patients to my already full load, it was only another 35 miles, get real, taking a day to shop or sneak around with someone's spouse is what I am seeing. I am rewarded by my patients knowing I am doing a good job for them, but no, I will not be staying in HH. I am glad for many it is what they want, but not for me.

hoolahan, ASN, RN · Nov 21, 2004

I have been rewarded with my patients care and I am doing my job, but, as I stated in an earlier post, 3 nurses quit in one day, I have had to cover for them, I have been to the homes of some of the people they were taking care of, I know the care was not given. I talked to the super, and CM about this, I was given some sort of explanation like, well some nurses are not as secure in their skills. Big whoop, are they even assessing. Also noted that supplies were ordered and never got to the home, told CM and it is being checked on but I have a feeling nothing will happen. At the weekly meeting it seems more interesting to gossip than discuss issues that need addressed. I expect work to be done, if it is not done, then there should be a good excuse, one person stated they were too tired to work that day, came to the office for 1 hour, saw 3 patients, and then disappeared. I was asked to add one of their patients to my already full load, it was only another 35 miles, get real, taking a day to shop or sneak around with someone's spouse is what I am seeing. I am rewarded by my patients knowing I am doing a good job for them, but no, I will not be staying in HH. I am glad for many it is what they want, but not for me.

Wow. It is even worse than I thought for you!! No wonder you have such a bad taste in your mouth. We have all been there with lazy nurses who don't pull their weight, but your agency seems to attract them like a magnet!! That is one of the things about Homecare. Employers really have to be able to trust their staff to be actually doing thier job. Most of us, like you, have the ethics to be there and do what we are supposed to be doing, but it sounds like you are alone in those values where you are working now. I have followed some people and wondered if they were blind when they made the first visit, how could they have not seen this abuse, this need for a MSW, etc...

I can't say I blame you one bit then. Hard to even feel rewards for yourself, when you know you couldn't rely on another nurse seeing one of your patient's for you if the need arose.

I do wish you luck in finding a position where you have a better team to work with and can enjoy your job a little more. {{{{barefootlady}}}}